ArticleBMC medical education2018
A mixed-methods exploration of cognitive dispositions to respond and clinical reasoning errors with multiple choice questions.
Article in BMC medical education, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Assessing the Capability of ChatGPT, Google Bard, and Microsoft Bing in Solving Radiology Case Vignettes.The Indian journal of radiology & imaging · 2024Article
- Article
- Effect of a simulated patient cases software on the clinical competence of medical students during pediatric clerkship.Sudanese journal of paediatrics · 2024Article
- Automated Item Generation: impact of item variants on performance and standard setting.BMC medical education · 2023Article
- Cognitive and Metacognitive Processes Demonstrated by Pharmacy Students When Making Therapeutic Decisions.American journal of pharmaceutical education · 2023Article
- Oral presentation assessment and image reading behaviour on brain computed tomography reading in novice clinical learners: an eye-tracking study.BMC medical education · 2022Article
- Implicit bias in healthcare: clinical practice, research and decision making.Future healthcare journal · 2021Article
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Authors and funding
4 authors.
Funding
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Abstract
backgroundCognitive dispositions to respond (i.e., cognitive biases and heuristics) are well-established clinical reasoning phenomena. While thought by many to be error-prone, some scholars contest that these cognitive dispositions to respond are pragmatic solutions for reasoning through clinical complexity that are associated with errors largely due to hindsight bias and flawed experimental design. The purpose of this study was to prospectively identify cognitive dispositions to respond occurring during clinical reasoning to determine whether they are actually associated with increased odds of an incorrect answer (i.e., error).
methodsUsing the cognitive disposition to respond framework, this mixed-methods study applied a constant comparative qualitative thematic analysis to transcripts of think alouds performed during completion of clinical-vignette multiple-choice questions. The number and type of cognitive dispositions to respond associated with both correct and incorrect answers were identified. Participants included medical students, residents, and attending physicians recruited using maximum variation strategies. Data were analyzed using generalized estimating equations binary logistic model for repeated, within-subjects measures.
resultsAmong 14 participants, there were 3 cognitive disposition to respond categories - Cognitive Bias, Flaws in Conceptual Understanding, and Other Vulnerabilities - with 13 themes identified from the think aloud transcripts. The odds of error increased to a statistically significant degree with a greater per-item number of distinct Cognitive Bias themes (OR = 1.729, 95% CI [1.226, 2.437], p = 0.002) and Other Vulnerabilities themes (OR = 2.014, 95% CI [1.280, 2.941], p < 0.001), but not with Flaws in Conceptual Understanding themes (OR = 1.617, 95% CI [0.961, 2.720], p = 0.070).
conclusionThis study supports the theoretical understanding of cognitive dispositions to respond as phenomena associated with errors in a new prospective manner. With further research, these findings may inform teaching, learning, and assessment of clinical reasoning toward a reduction in patient harm due to clinical reasoning errors.
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